title: Chronic kidney disease as a coronary disease equivalent--a comparison with diabetes over a decade.
abstract: OBJECTIVE
  Whether chronic kidney disease (CKD) should also be considered a coronary disease equivalent like diabetes is not clear.
  
  
  METHODS
  Veterans with and without diabetes and with and without CKD were prospectively recruited. A competing Cox regression model was used to describe the risk of myocardial infarction (MI) in the two groups (CKD and diabetes) over a decade of follow-up.
  
  
  RESULTS
  The incidence rate of MI in those without CKD was 0.047/yr and in those with CKD was 0.206/yr. Multivariate adjustment revealed the incident rate ratio for MI in CKD as 3.5 and for diabetes mellitus as 2.5. The cumulative incidence for MI was influenced by CKD and diabetes. CKD was associated with a subhazard ratio for MI of 3.74; in contrast, diabetes was associated with a subhazard ratio for MI of 2.6. For the outcome of all-cause mortality, after multivariate adjustment, CKD was associated with a hazard ratio (HR) of 1.86, which was similar to the HR of 2.27 for prevalent coronary artery disease. The HR for diabetes was NS at 1.35.
  
  
  CONCLUSIONS
  CKD is associated with a risk of death similar to that of established coronary artery disease and higher than that of diabetes mellitus. CKD is associated with a risk of MI that is at least as much as that from diabetes mellitus. Among veterans, CKD appears to be a coronary disease equivalent.
authors.affiliation: Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
authors.forename: Yalew T
authors.initials: YT
authors.lastname: Debella
authors.forename: Habtamu D
authors.initials: HD
authors.lastname: Giduma
authors.forename: Robert P
authors.initials: RP
authors.lastname: Light
authors.forename: Rajiv
authors.initials: R
authors.lastname: Agarwal
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002908:Chronic Disease; D003327:Coronary Disease / Q000453:epidemiology* / Q000401:mortality; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D007196:Indiana / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D007674:Kidney Diseases / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000401:mortality; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014728:Veterans / Q000706:statistics & numerical data